[Functional weakness of movement]. / Trouble du mouvement d'origine fonctionnelle.

The diagnosis of functional paresis is evoked when a patient presents with symptoms and signs incompatible with current anatomical and physiological knowledge. A broad assessment, including imaging and motor evoked potentials at rest, remains necessary; the rate of false diagnosis being estimated at 4%. The mechanisms of hysteria remain still dubious but various studies suggest that functional paresis is different from simulation by conscious, voluntary inhibition. The long-term prognosis is bad. The treatment includes cognitive-behavioral therapy and rehabilitation to develop a positive attitude.

[Expansion of the sphere of crisis: the question of the intrusiveness of the disease]. / Extension du domaine de la crise: la question de l'intrusion de la maladie.

The passage to ambulatory care of a patient with a long hospital stay due to a wrenching disease is not something obvious. The doctor and the care staff will have to take up the challenge of dealing with an important amount of care. The quality of life of the patient and his caregivers is influenced by the neuropsychiatric disorders, the illness intrusiveness and the depression that come along with them. The chronic disease intruding causes a crisis in their lives. In order to better evaluate these factors we are using the Illness Intrusiveness Rating Scale developed by Devins. This article addresses the high complexity of clinical situations handled in an environment of rehabilitation care with the support of the consultants, nurses and doctors, of the liaison psychiatry.